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In the same way that some of us are from the beach and others from the mountains,
the different variants of coronavirus also have their preferences about where to set up camp
and reproduce.
Omicron
has decided that she
is more comfortable
reproducing in the
throat
while her older sisters had a predilection for the lungs.
We are facing
a new paradigm shift
in this disease that changes our pace daily.
To begin with, the fact that
there is more viral load in the throat can cause the variant to be more contagious now
(we spend the day talking) or that among the
symptoms we have incorporated
sore throat
as frequent
.
Another novelty is the declarations of experts who during the last days
assess whether the traditional way
in which we are taking the sample is really the most appropriate now.
Are we making a mistake by taking the sample only in the nose? What does science say?
In a study conducted at the University of Cape Town in South Africa, the diagnostic tests of 382 COVID-19 patients were compared.
In patients
with the delta variant of the coronavirus, saliva swabs detected the virus 71% of the time
, while nasal swabs found it 100% of the time.
The surprise was that in
omicron patients, just the opposite occurred: saliva swabs detected the virus 100%
of the time, while nasal swabs detected it 86% of the time.
Another recent study found that
in the three days before and two days after the onset of symptoms
, saliva samples
contained about three times as much virus as nasal samples
and were 12 times more likely to be
PCR positive
. If this is true, if we were able to detect the positive one day earlier depending on the type of sample, many infections could be avoided.
Although it all sounds very logical, the truth is that
both studies (and others with similar characteristics) are preliminary
and have not yet been published in scientific journals.
The evidence we still have in this regard is very weak.
Being aware of this, numerous
epidemiologists and immunologists in the US have decided to open the melon about the advisability of changing the type of sample
taking by additionally taking a throat sample.
They believe that despite the inconclusive evidence, we should start making decisions and taking action.
The reality is that
the coronavirus is always two steps ahead of us.
The coronavirus
lives inside a song by Chenoa
and when we go he has already returned.
What do the health authorities say?
For now ,
the instructions on how to perform the tests have not changed
and it is not recommended to do "home experiments" by modifying the instructions indicated by the manufacturer.
In fact, proponents of throat swabs, including one of its greatest exponents, Michael Mina, a former epidemiologist and immunologist at the Harvard TH Chan School of Public Health,
also do not endorse the practice for the general public until approved
by the public.
part of the regulatory agencies.
That is to say: the very experts who have opened the debate and who recognize that they themselves take the double sample (throat + nose) at home
affirm that they do so under their responsibility but do not encourage the population to act contrary to the instructions of the test
.
As scientists they admit that this is not the way the tests have been developed and tested and that more research is needed.
What are the drawbacks?
In the first place, although it seems that the classic nasal swab tests could be suitable for throat swabbing,
they need to be tested for this purpose since we do not know the number of false positives or negatives
that the throat swab can cause.
On the other hand, there are some practical drawbacks when taking the sample.
In some patients it could produce greater rejection
(in fact gagging is frequent) or it may be difficult to obtain a correct sample on the palate.
How would be the ideal sampling?
Although, as we have explained,
it is not indicated for the general population,
some experts suggest that the ideal would be a double sample, taken first from the throat and then from the nose.
In fact,
in the United Kingdom they recommended doing it this way for a long time and they released informative videos
to teach the general population how to do it.
However, due to the difficulty many people experienced in taking the throat sample
, it was later decided to simplify and recommend only nasal sampling.
Firstly
, the swab should be rubbed on the soft part of the palate
, on both sides of the bell, and then the
smear should be made in the usual way on both nostrils
.
It is important to note that to avoid errors
you should not eat, drink, smoke or chew gum during the 30 minutes prior
to the test.
It has been observed, for example, that
traces of orange juice could create a false positive
in the antigen test.
Saliva test: the alternative
An alternative that in principle seems simpler to double sampling would be to favor the use of saliva tests.
In fact, this week there has been
a free delivery of this type of test in Galician schools
.
However, there is no official evidence or indication that performing this type of test is preferable to nasopharyngeal tests.
For now it is considered that both are equally valid and reliable if they are done at the right time and in the right way.
In fact,
although a priori sampling seems simpler ("spitting into a tube" is easier than "putting a stick")
, the truth is that doing it correctly has a little more crumb.
First of all
, you have to cough deeply, three to five times
, and
push the saliva from the bottom of the throat to the mouth
so that the saliva is not superficial and comes from the throat.
This is something that for some people (especially children or older people with dry mouth) can be difficult.
If the sample is superficial, we run the risk of false negatives.
In summary:
for the moment "
we stay as we are
", doing
the nasal tests in the manner indicated by the manufacturer
, but with the antenna on (and jaws open) waiting for the recommendations to change at any time.
Hopefully, for once, we can get ahead of the bug.
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